A. Field of the Invention
The invention relates to pathologic conditions known as temporomandibular joint disorders and to a method and apparatus for treating them.
B. Prior Art
Temporomandibular joint disorders ("TMJ disorders") are pathologic conditions of the craniomandibular articulation which affect mandibular opening, mastication, and deglutition. A common type is internal derangement. Mild internal derangement of the TMJ may manifest itself as a "clicking" or "popping" of the disc within the joint. More severe symptoms include headache, neck pain, back pain or facial pain. Stooping and altered head and body posture may be additional signs of disorder of the craniomanidibular articulation. The problem is widespread: It has been estimated that up to 50% of the population seeking dental treatment exhibits some degree of TMJ dysfunction. The nature of the disorder is described more fully in an article by myself and by F. J. Ramos-Gomez entitled "Treatment of Temporomandibular Joint Related Headaches In the Pedodontic Patient: A Preliminary Report" appearing in the Journal of Pedodontics, Vol. 6, No. 2 (Winter 1982.).
One method of treatment for craniomandibular disorder (internal derangement) includes repositioning the mandible, usually in a more forward and opened position. Typically, this is accomplished by means of an appliance which is attached to the upper or lower teeth or by a "European style" appliance for maintaining a preset mandibular position. Such appliances typically comprise a number of "pads" (usually of hard, acrylic plastic) fitted to selected teeth and joined by structural wires which reposition the mandible. Screw-type adjustments are usually provided in the appliance to accomodate changes in the user's condition. These appliances may be cosmetically unattractive or sore to the gingival tissues, and have served as a barrier to treatment by some who could benefit from it. Further, they are time consuming to fabricate and adjust, and may be uncomfortable or cumbersome for the patent. A survey of the development and construction of some typical maxillofacial appliances is set forth in an article entitled "The Historical Development of Maxillofacial Orthopedic Techniques" authored by the applicant and appearing in The Bulletin Of The History of Dentistry, Vol. 30, No. 2, Oct. 1982.
Careful fitting and fabrication of the appliances is also a requisite to successful treatment. Typically, the fabrication is done in dental laboratories by skilled technicians who operate from a casting made by the clinician who is treating the patient. The fabrication is expensive, and the requisite technical laboratory skills are frequently lacking in many countries. In many areas of the world, therefore, a significant portion of the population is barred from access to the effective treatment of craniomandibular disorders.